Standard processing techniques for radical prostatectomy specimens uniformly require initial formalin fixation. Fresh prostate cancer tissue is needed for many types of prostate cancer research and may be needed for diagnostic purposes in the future. We describe a method for processing radical prostatectomy specimens that allows pre-fixation sectioning and harvest of fresh prostate cancer tissue. Because of increased difficulty interpreting capsular margin sections, however, we do not recommend it for routine use. We review other methods of radical prostatectomy specimen processing and provide an algorithm for their appropriate use.